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Incontinence is a difficult battle for a caregiver, and especially when the person they are caring for suffers from Alzheimer’s Disease. This area of care is sensitive, and can be very frustrating for a caregiver. In addition, it is imperative that this care be handled correctly to avoid skin break down or other medical-related issues. It is common that when a person has Alzheimer’s, they are not able to cooperate for the caregiver, which increases their own agitation while making it stressful for the person providing the care. Are you caring for a person with Alzheimer’s and Incontinence? Here are some tips on how to work through this with your loved one.


First, is the incontinence a new problem? You should try and rule out a medical condition that could be the cause. For example, Urinary Tract Infections can be a cause of urinary loss of control. In addition, when cognition problems are present, the person doesn’t have the ability to tell their caregiver about their symptoms. Watch out for symptoms such as increased confusion, agitation, weakness, and falls. It is also important to know that other medical issues, such as diabetes, stroke, Parkinson’s Disease, constipation, and prostate troubles may cause a change in bladder control.


Monitoring medications and fluid intake will also help. Have any medications been added or changed recently? Look at those first, as certain medications could have side effects that cause loss of urinary control. For example, sleep aides and anxiety medications have been known to relax the muscles of the bladder. In terms of fluid, it is important for you to know that there are drinks that can act as a diuretic. These include but are not limited to soda, tea, and coffee, and can make it harder to control the bladder. You should not withhold fluids, as that will lead to Urinary Tract Infections and dehydration, but it is good practice to monitor fluid intake and choices, and maybe limit how much is taken before bed.


If you have ruled out all of these possible problems, consider environmental factors that could contribute to the incontinence. Is it possible that the person you are caring for no longer remembers the way to the bathroom? Does clothing make it difficult for them to use the bathroom successfully? With cognition problems, buttons and zippers can become difficult to understand. Elastic-wasted pants may be much less complicated and faster to pull up and down. Another possibility is that your loved one doesn’t remember to go to the bathroom. Regular toileting routines and reminders may avoid accidents. Prompting your loved one every 2-3 hours to try and use the bathroom could help avoid incontinence problems.


Patients with severe cases of dementia may no longer remember what the word bathroom means. Think about your terminology and consider the time period when that person lived when restroom or washroom may have been used. You may also find that they are resistant to wearing protective underwear, as the term diaper causes embarrassment and doesn’t preserve their dignity. It is important for their recognition that you use words that are familiar to them. Call them underwear or something the person knows as undergarments. There really is no reason to identify how they are different from regular underwear to a person who suffers from confusion.


Lastly, remember to be respectful and stay calm. Recognize that your loved one deserves dignity. Refrain from saying things like, “Oh look, you wet your pants.” Instead, consider, “Let’s freshen up and change your clothes”, or “ You must have spilled something”. A person with Alzheimer’s Disease can sense frustration and the mood of the caregiver can affect how the person responds to the approach. As always, be creative in your approaches and tailor your responses to the one you are caring for.


Our team members at Western Illinois Home Health Care have been trained and certified in the Alzheimer’s Whisperer Program through experts at C&V Senior Care Specialists. We will help you in accomplishing these difficult tasks, reducing your stress, and providing necessary breaks to you as a caregiver. Our nurses are trained to provide support through skilled-services. Our goal is to help you keep your loved one at home as long as it is safe and possible. If you or someone you know is having difficulty caring for their loved one, please call us today at 1-800-228-5993.


Amanda Powell, BSW, is a Senior Care Manager at Western Illinois Home Health Care


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Caring for Someone with Alzheimer’s Disease and How to Handle Incontinence

February 2015

by Amanda Powell